What is Menometrorrhagia?
Menometrorrhagia is a type of menstrual abnormality that causes extreme menstrual blood loss in women of various ages. This article discusses the definition, causes, symptoms and treatment options of this condition.
Menometrorrhagia is the name of a condition characterized by excessive or prolonged uterine bleeding that occurs very frequently. There are numerous factors that can lead to this disorder.
It is classified into the two following types:
It causes prolonged, abnormally heavy menstruation at regular intervals.
This form of the condition is characterized by uterine bleeding occurring at irregular intervals, usually between the anticipated dates of menstrual periods.
In some cases, the disease may occur due to unknown causes. In most instances, however, Menometrorrhagia is caused by one or more of the following factors:
An imbalance in the estrogen and progesterone hormones may result in an excessive production of endometrium, which causes heavy menstrual bleeding.
Dysfunction of the ovaries
Sometimes, the production of progesterone during menstruation is held back due to lack of ovulation. This is another reason for hormonal imbalance which can cause Menorrhagia.
Benign tumors that may develop during the childbearing years of a woman are called uterine fibroids. These can lead to abnormally heavy bleeding.
Uterine polyps are small benign outgrowths on the uterine wall lining that can result in this menstrual disorder.
Sometimes, the endometrium (the mucus membrane lining the uterus) becomes embedded in uterine muscle. This often causes heavy menstrual bleeding.
Intrauterine device (IUDP)
Using non-hormonal intrauterine devices for the purpose of birth control is another possible cause.
Pregnancy complications like miscarriage may lead to a single, heavy late menstruation.
Ovarian cancer, uterine cancer, endometrial cancer, primary fallopian tube cancer and cervical cancer are counted among the possible causes of this disorder.
Inherited bleeding disorders
Certain blood coagulation disorders (e.g. Von Willebrand’s Disease) can be a reason behind abnormal menstrual bleeding.
It can also be caused by improper use of various drugs including several anticoagulants, anti-inflammatory medications and hormone medications.
Other medical conditions
Various other disorders such as Endometriosis, thyroid problems, PID (Pelvic Inflammatory Disease), liver diseases and kidney diseases are often associated with Menorrhagia.
Other possible causes may include:
- Various stress-related disorders
- Sexually Transmitted Infections
- Dysfunctional uterine bleeding
- Endometrial hyperplasia
- Pelvic inflammatory diseases
- Diet that can trigger ketosis
Alcohol and drug intake are also counted among the risk factors for developing this type of menstrual irregularity in some women.
Menometrorrhagia Signs and Symptoms
The symptoms of both types of the disorder are quite similar. The common signs of the condition include:
- Extremely heavy bleeding during menstruation that can interfere with the daily activities of the patient
- Bleeding between regular menstrual periods
- Less than twenty-one days or more than thirty-five days between periods
- Continuation of menstrual periods for more than 7 days
- Constant aching in and around the lower abdomen area during periods
The symptoms of anemia, due to extreme blood loss, generally include:
- Shortness of breath
- Numbness along with a tingling sensation in toes and fingers
- Poor concentration
- Decrease in body temperature
In most cases, there is no way to prevent this condition. However, if the menstrual abnormality is resulting from some medication, one can prevent it by discontinuing the use of the responsible drug.
A gynecologist thoroughly studies the medical history of the patient. He or she also performs a pelvic examination to look for any indication of any mass in the ovary or uterus for diagnosing this disorder. The presence of an ovarian mass and fibroid in the uterus can be confirmed by an abdomen ultrasonography. In some instances, a doctor may order a diagnostic laparoscopy that involves visualizing the pelvic structures using a fiber-optic device which is inserted into the abdomen of a patient through a tiny incision. Evaluating the functioning of the thyroid is usually required for eliminating the possibility of Hypothyroidism. The following diagnostic tests may also be used for this purpose:
- Blood tests
- Pap test
- Endometrial biopsy
- Pregnancy test
- Dilation and curettage
Menometrorrhagia Differential Diagnosis
There are many conditions that have similar symptoms like the Menorrhagia form of this disorder. Not much is known about the differential diagnosis of Metrorrhagia. The differential diagnosis of Menorrhagia involves eliminating the possibility of:
- Incomplete abortion
- Ectopic pregnancy
- Threatened abortion
- Cervical neoplasia/polyp
- Cervical ectropion/erosion
- Vaginal or cervical trauma
- Atrophic Vaginitis
Pelvic Inflammatory Disease or PID
Menometrorrhagia Treatment and Management
The treatment of this disease depends on several factors including the medical history and overall health, the underlying causes as well as the severity of the symptoms of a patient. The tolerance of a patient for specific therapeutic procedures, medication and her future childbearing plans also play decisive roles in the treatment. Complete bed-rest is very important and a patient should also avoid strenuous activities as it may aggravate the condition.
It is often treated by various drugs and medication. There are several forms of medication that can be used for this purpose.
A doctor may prescribe an iron supplement if the patient has anemia as an associated condition. Regular iron supplements can help to improve anemia. This supplement is also recommended in cases where the patient has low iron levels without actually being anemic.
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NSAIDs or Nonsteroidal anti-inflammatory drugs
NSAIDs like ibuprofen (Motrin, Advil) and naproxen (Aleve) can be beneficial for reducing the menstrual flow. These medications also help to relieve dysmenorrheal or painful menstrual cramps.
Oral birth control pills are effective in regulating menstrual cycle, preventing prolonged periods and reducing menstrual bleeding. These pills are often used for controlling various menstrual irregularities.
Taking oral progesterone for at least ten days of each menstrual period can help in the correction of hormonal imbalance.
Hormonal IUD (Intrauterine Device)
Hormonal IUD (Mirena) is another possible treatment option for treating this disorder. This intrauterine device helps to reduce menstrual bleeding and relieve cramping by releasing a kind of progestin named levonorgestrel which assists in the thinning of the uterine lining.
In cases where the Menometrorrhagia is resulting from the use of certain hormone medication, a doctor may cure the problem by changing or discontinuing the drug.
Severe cases of the condition may require surgical intervention. The following treatment options are used if the drug therapy fails to solve the irregularities in menstruation:
Dilation And Curettage
This is a surgical procedure which involves dilating the patient’s cervix for scraping excessive tissues from the uterus lining to reduce menstrual blood flow. D&C is often used for treating Menometrorrhagia successfully. However, the patient may need additional D&C surgery if the condition recurs.
In this procedure, a hysteroscope (a tiny tube having a light attached to it) is used for viewing the uterine cavity and for removing any polyp that may be responsible for the excessive menstrual bleeding.
In some cases, the doctor may use various surgical techniques for destroying the entire uterine lining (endometrium) permanently. Women who have received endometrial ablation surgery generally have slight or no menstrual bleeding. This surgical procedure reduces a woman’s ability to conceive.
In this surgery, the uterus lining is removed by the surgeon using a small electrosurgical wire loop. Both the endometrial resection and endometrial ablation procedures are beneficial for women having extremely heavy menstrual bleeding. Like with the endometrial ablation, a woman may find it difficult to become pregnant after this surgery.
In some cases, the uterus and the cervix are removed by surgery which results in infertility and the cessation of menstrual cycles. Hysterectomy requires hospitalization and is executed during anesthesia. Performing a bilateral oophorectomy (removing the ovaries) along with hysterectomy may result in premature menopause.
Apart from hysterectomy, all these surgeries are generally performed on outpatient basis where a patient does not have to remain at the hospital overnight after surgery. Although, all the procedures require general anesthesia, the patient is usually able to go home a few hours after the surgery.
If the Menometrorrhagia is caused by some other health condition such as some thyroid disease, treating the underlying condition results in reduced menstrual flow.
Menometrorrhagia Natural Treatment
There are various Ayurvedic and natural treatment options that can effectively cure this menstrual problem. Know about some of these popular remedies:
- Saraca Indica and Symplocos racemosa are two herbs that have been used by Ayurvedic practitioners for this purpose over a long period of time.
- Making a paste using seven pomegranate leaves and seven rice grains and giving it to the patient twice daily for around a month can help to keep the condition under control.
- Drinking two cups of rosehip tea everyday can help to reduce the heavy menstrual flow by increasing the intake of flavonoids and vitamin C.
- Boiling some fresh parsley leaves in a cup of water and drinking the decoction 3 times during the first three days of menstrual cycle can be beneficial.
- Fenugreek water can be helpful for decreasing menstrual bleeding and for alleviating the menstrual cramps during periods.
- The medicinal flower marigold can also be used as an effective herbal remedy for this disorder.
Sometimes, acupuncture is used for treating this type of menstrual abnormality. It can be helpful for regulating menstruation as it can control the production of luteinizing hormones.
Excessive blood loss over a long period of time may lead to various health complications. The blood loss may become greater than the iron reserves of the body or its blood replenishment rate and can gradually lead to severe anemia.
The prognosis or outcome of the disorder is generally positive with proper treatment. In majority of the instances, the patients are successfully cured with medications while comparatively severe cases are cured with suitable surgical procedures.
Menometrorrhagia is a menstrual abnormality that can hamper the daily activities of a woman. It can be treated with medications and surgery. It is not advisable to leave this condition untreated as it may lead to various more serious health problems.